Anxiety and Anxiety Disorders
What Is Anxiety?
Section titled “What Is Anxiety?”You can only defeat anxiety by facing it. Anxiety is a state in which you believe it could kill you. If you do not face the anxiety, it spreads proportionally in space and time.
First and foremost, anxiety is a natural protective mechanism of every living being. Without anxiety, we could not survive. Nevertheless, in humans it is a state that results from a mixture of feelings that can no longer be classified.
Anxiety means:
Section titled “Anxiety means:”- The knowledge of not knowing and its consequences
- An inability to calculate the situation (since humans think linearly)
- Psychological disorientation
Symptoms of Anxiety States
Section titled “Symptoms of Anxiety States”The symptoms can be varied and do not occur in everyone:
Physical Symptoms
Section titled “Physical Symptoms”- Racing heart
- Heart palpitations
- Eyelid fluttering when lying down
- Dizziness
- Chills
- Trembling
- Sweating
- The feeling of losing the ground under one’s feet
- Shortness of breath
- Gagging sensations
- Vomiting
- Gastrointestinal complaints
Further Physical Symptoms
Section titled “Further Physical Symptoms”- Menstrual irregularities
- Lower abdominal pain
- Chest pain
- Heart pain
- Nightmares, sleep disturbances
- Skin irritations (crawling sensations, skin burning, itching)
- Concentration and memory difficulties
Anxiety and Borderline
Section titled “Anxiety and Borderline”The Typical Pattern
Section titled “The Typical Pattern”A borderline personality typically knows only one way of coping with anxiety: running away.
However, if the borderline individual is attacked in a state of aggression, they do not act with the natural protective function of anxiety. Instead, they do everything to destroy the “opponent.” The anxiety grows massively within them. To counteract it, they become increasingly brutal and resort to means that can no longer be justified by anything.
Free-Floating Anxiety
Section titled “Free-Floating Anxiety”Free-floating (non-object-directed) anxiety is part of borderline personality disorder. Borderline individuals have no or hardly any defense mechanisms, which makes their reactions often completely incomprehensible to partners.
Social Anxiety
Section titled “Social Anxiety”For many borderline individuals, social anxiety also plays an enormous role. Therefore, very many borderline individuals have the additional diagnosis (comorbidity) of an anxiety disorder:
- F40.9 - Phobic disorder, unspecified
- F41.x - Other anxiety disorders
- F45.2 - Hypochondriacal disorder
Forms of Anxiety Disorders
Section titled “Forms of Anxiety Disorders”Generalized Anxiety Disorder (F41.1)
Section titled “Generalized Anxiety Disorder (F41.1)”- Persistent anxiety not restricted to specific situations
- “Free-floating” anxiety
- Constant apprehensions and worries
- Physical tension
Panic Disorder (F41.0)
Section titled “Panic Disorder (F41.0)”- Recurring severe anxiety attacks (panic attacks)
- Not restricted to specific situations
- Sudden onset
- Racing heart, chest pain, feelings of suffocation, dizziness
- Fear of dying, going crazy, or losing control
Phobic Disorders (F40)
Section titled “Phobic Disorders (F40)”Agoraphobia (F40.0)
Section titled “Agoraphobia (F40.0)”- Fear of public places
- Fear of crowds
- Fear of traveling alone
- Fear of leaving the house
Social Phobia (F40.1)
Section titled “Social Phobia (F40.1)”- Fear of being scrutinized by others
- Avoidance of social situations
- Fear of criticism or rejection
- Often associated with low self-esteem
Specific Phobias (F40.2)
Section titled “Specific Phobias (F40.2)”- Fear restricted to specific situations or objects
- Examples: fear of heights, flying, spiders, blood phobia
Hypochondriacal Disorder (F45.2)
Section titled “Hypochondriacal Disorder (F45.2)”- Excessive preoccupation with the fear of having a serious illness
- Misinterpretation of physical symptoms
- Persistent worries despite medical reassurance
Anxiety vs. Anxiety Disorder
Section titled “Anxiety vs. Anxiety Disorder”| Normal Anxiety | Anxiety Disorder |
|---|---|
| Appropriate reaction to real danger | Excessive reaction without real danger |
| Temporally limited | Persistent or recurring |
| Does not substantially impair life | Leads to significant limitations |
| Can be controlled | Feeling of loss of control |
| Helps with survival | Impairs quality of life |
The Vicious Cycle of Anxiety
Section titled “The Vicious Cycle of Anxiety”- Triggering situation - external or internal stimuli
- Physical symptoms - racing heart, sweating, trembling
- Perception - “Something is wrong with me”
- Catastrophizing thoughts - “I’m dying, going crazy”
- Intensification of anxiety - panic increases
- Avoidance behavior - situation is avoided in the future
- Short-term relief - but long-term worsening
Treatment Options
Section titled “Treatment Options”Psychotherapy
Section titled “Psychotherapy”- Cognitive behavioral therapy - Identification and modification of anxiety-triggering thoughts
- Exposure therapy - Gradual confrontation with anxiety-triggering situations
- Relaxation techniques - Progressive muscle relaxation, breathing exercises
Pharmacological Treatment
Section titled “Pharmacological Treatment”- Antidepressants (SSRIs, SNRIs)
- If needed, short-term benzodiazepines (with caution due to dependence potential)
Self-Help
Section titled “Self-Help”- Regular exercise
- Avoiding caffeine and alcohol
- Sufficient sleep
- Learning relaxation techniques
- Self-help groups